Lilium is, according to its recent provings, a very near analogue of cactus.
Acidum hydrocyanicum is another remedy closely allied to digitalis. In proof of this, I have but to cite you to Dr. Handfield Jones’ experiments. He says, “In poisonous doses it produces tetanic convulsions, preceded by faintness and giddiness. After death the heart is well and firmly contracted, its tissue remarkably firm, the cavity of the left ventricle almost quite obliterated, that of right small, but little blood in either, coagula in both auricles.” Stille says, “the whole venous system is gorged and distended with dark uncoagulated blood,” which implies that, owing to the tetanic contractions of the heart, the circulation was suspended. I consider this remedy useful in high potencies to quell the excessively forcible action, pain like angina pectoris, and for other symptoms found in its pathogenesis. Use the 6th or 30th centennial dilution.
There are many agents, chemical and vegetable, which contain hydrocyanic acid in appreciable quantities. These all have, in a less degree, the same specific action on the heart and its nervous supply. The most potent of these is the
Cyanide of potassium, which may be used in the 6th or 30th potency for similar symptoms and conditions.
Laurocerusus is another which possesses many notable and important heart symptoms.
Prunus virginiana (wild cherry) amygdalus persica (peach) both contain acidum hydrocyanicum, and have long been used to quiet and regulate abnormal action of the heart. Their use, in infusion of the bark, has doubtless been injurious in hypertrophy with enlargement, but in the 2nd or 3rd dilution would no doubt be beneficial.
lycopus virginicus* *New Remedies. 2nd Edition. possesses powers closely allied to the above medicines. In the dilutions below the 3rd you will find it beneficial in hypertrophy with a tendency to, or actual haemoptysis and cough.
Amygdala amara (bitter almonds) contain hydrocyanic acid. I have know patients troubled with palpitations from hypertrophy get considerable relief from eating two or three after each meal.
Repetition of medicines. If you have carefully selected one of the above for the case you are treating, give it a fair trial. Do not change the medicine unless the symptoms materially change, but continue its use for days and perhaps weeks. The repetition of the dose will depend on the amount of cardiac disturbance. Four doses a day, unless frequent palpitations or severe congestions occur, in which cases the medicine may be repeated every hour or two.
The remedies of the third class, namely: nux vomica, ignatia, cinchona, ferrum, hydrastis, collinsonia, and sulphuric acid, do not differ very widely, in their ultimate effects on the heart, from those of Class II. Both classes primarily increase the innervation and tonicity of the heart, by acting through different channels. Nux vomica acts through the cerebro-spinal nerve-centres, while digitalis operates through the great sympathetic.
I will now give you the indications for this class:
Nux vomica, I assure you, has not been sufficiently appreciated in hypertrophy of the heart. It is indicated in the concentric and eccentric form. But it is of the former only that I will now speak.
Dr. Ch. Muller* *Homoeopathic Examiner Vol. V. says of this medicine, “It causes palpitation in frequent short paroxysms, with commotion of blood; pulsating throbs in the direction of the heart; great anxiety, with severe palpitation. In the numerous and careful post-mortem examinations which have been made in cases of poisoning with nux, no organic alterations about the heart have been found. Its influence on the heart must be referred to the nervous system. It causes increased activity and evident irritation of the ganglionic system, which may be propagated to the mind and senses; hence the above-mentioned heart-symptoms may arise in consequence of sympathy with the ganglionic and mental affections. For this reason Hahnemann laid so much stress on the presence of vexability, over-sensitiveness to all impressions, hypochondriacal humor, passionate irritability and sudden choler, great anxiousness, starting in affright, fearful, anxious dreams, etc., as strong indications for the use of nux vomica. Hence, nux cannot prove homoeopathic to any heart affection dependent upon any organic or material change of structure.”
I cannot agree with Dr. Muller in his estimate of this medicine. Because no structural change was found in the heart from acute nux-poisoning, it does not prove that hypertrophy may not be caused by its long-continued pathogenetic effects. You will remember that hypertrophy is rarely a primary disease. It is generally brought on from obstructions somewhere else, in the circulation, or in important organs. That the chronic poisonous effects of nux vomica on the liver, intestinal canal, and spinal cord, will cause hypertrophy, I have no doubt. It will not cause, directly, the thickening or thinning of the heart-walls, but it will cause disorders which lead to that result.
The translator of Dr. Muller’s paper says, “Nux vomica acts predominantly and specifically on the motor side of the spinal marrow and the muscular system in general, and tends more particularly to cause tetanic spasms; as the heart is a very muscular organ it is probable that it exerts a similar action on it; in fact, the spasm of the heart may become so complete and persistent, that this organ remains tightly contracted for some time, during which little or no impulse is felt, the respiration being difficult and the pulse extinct. If the spasm of the heart be less complete and tonic, i.e., more atonic, then violent palpitation may ensue. But nux vomica constantly tends to produce long-continued spasmodic contraction of the heart. According to sorbenheim it often causes an asphyxiated condition, dependent upon an extremely violent contraction of the respiratory muscles and heart. Every one familiar with diseases of the heart must be familiar with this state of things: a patient with organic disease of the heart will be suddenly taken with what he calls spasms; he sits in speechless agony, his hands clasped over the cardiac region, his eyes protruded, his face livid; the physician attempts to feel the pulse and can scarcely find it; he places his hand or ear over the heart, and finds everything still and motionless as death itself; after a while the spasm relaxes; more or less palpitation follows, and the patient recovers for the time. Such attacks are often mistaken for paralysis, exhaustion, or debility of the heart, and treated with stimulants.”
This writer asserts that nux is homoeopathic to enlargement of the heart with thickening of its walls, which assertion I accept, but only as relates to its primary effect, for the secondary effects of the above-described action of nux will just as certainly be dilatation of the heart, with atony of its remaining muscular fibres, even to paralysis.
You will doubtless read some authorities, who, like the writer I have quoted, will assert that the action of digitalis is opposite to that of nux. This is not the case, unless the statement is qualified. The primary action of both is very similar, so is the resulting secondary effect. It might be said that the secondary effect of digitalis was the opposite of the primary action of nux; such an assertion would be correct.
Nux vomica, therefore, is indicated for simple hypertrophy, i.e., when the walls of the heart are thickened, the cavity retaining its natural dimensions; also in that variety of hypertrophy in which the walls are considerably thickened, and the cavity dilated; and in hypertrophy with contraction, in which the walls are thickened and the cavity diminished in size. But, before you venture to prescribe nux vomica, be sure of your diagnosis, for if you give it in too large doses in the above conditions, you will surely get severe aggravations, and injure your patient, because they are conditions simulating the primary effects of nux, and calling for the highest attenuations, namely, from the 12th to the 200th, or even higher.
Ignatia is indicated for the same pathological conditions as nux vomica, but the selection must depend on the mental symptoms and the sex of the patient. Ignatia is more suited to women, or men with feminine dispositions, to patients who weep easily, or laugh and cry alternately; in other words, persons of hysterical temperament; and for hypertrophy when caused by the remote effects of grief, care, or other mental trouble. Prescribe the higher attenuations, not too often repeated. (Nux and ignatia are also Homoeopathic to hypertrophy with dilatation and attenuation of the heart-walls, but of this I will speak in my next lecture.)
China, or cinchona, has not been used by the homoeopathic school to any extent in diseases of the heart, yet I consider its action analogous to that of digitalis and nux, or as holding an intermediate relation to them. Hahnemann’s observation that in cases of poisoning from digitalis, china causes terrible anxiety and aggravation, is one of the best proofs that, in their primary action on the heart, they act similarly.
Hale wrote Lectures On Diseases Of The Heart, Materia medica and special therapeutics of the new remedies Volume 1, Materia Medica And Special Therapeutics Of The New Remedies Volume 2, Saw Palmetto: (Sabal Serrulata. Serenoa Serrulata), The Medical, Surgical, and Hygienic Treatment of Diseases of Women, New Remedies: Their Pathogenetic Effects and Therapeutic Application, Ilex Cassine : the aboriginal North American tea, Repertory to the New Remedies with Charles Porter Hart, The Characteristics of the New Remedies, Materia Medica and Special Therapeutics of the New Remedies, The Practice of Medicine, Homoeopathic Materia Medica of the New Remedies: Their Botanical Description etc.